8173 E CARNATION WAYPermit Types
4 BLD ELE MEC PLM
X
Permit Number: BLD2022-05109
Issued: 10/26/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 213
CITY OF ANAHEIM
Site Address: 8173 E CARNATION WAY, ANAHEIM, CA 92808
Legal Description: N TR 10.981 BLK LOT 4
APN:15411104
Project Description: Electrical for 200A main panel upgrade
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Living Area: Number of Stories: 0 Valuation: 0.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinldered:
Cool Roof: Total Fees paid for Permit: 167.00
People Associated with Project:
Permit Applicant Ben Medina
Owner LUX DAVID 8 DENISE 8173 E CARNATION WAY
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Meter/Disc Sw - Under 600 V, up to 200 1
amps
The permit shall expire by limitation and become null and void if the building or work has not passed final inspection 365 days from the
date of permit Issuance. A new permit Is required to commence or continue work.
P�PNEIM Cq<
City of Anaheim o� io
Building Division z
u D
�OVNOED �6y�
Do not occupy this building until the final inspections have been made.
FINAL INSPECTIONS DATE INSPECTOR
All applicable items below must be signed before utilities,are released
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714) 765-4280
Engineering Final (714) 765-5126
INSPECTION I DATE I INSPECTOR
Fire Sprinkler (ONLY) (714) 765-5041
Do not pour concrete until the following applicable items have been signed:
Fire Dept. Final (714) 765-5041
Plumbing (Ground/Underfloor Drain Waste)
Water Engineering (714) 765.4591_
Electrical Ground Electrode/Ufer
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches (Footings)
COAIMigation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building Inspections
r#== R f) A iq '
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Floor (Joist/Girders)
NXI 0
Underfloor Insulation (Raised Foundation Only)
b
Floor Nailing (Raised Foundation Only)
2nd Floor (Floor Nailing)
LjrAI LZ• 12 I16 22
Do not cover or conceal the work below until the following applicable items have
been e•
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
Plumbing Inspections
Framing (Only after Plbg., Ele., Mec. & Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele, Mec & Plbg)
Interior Lath
Exterior Lath
Electrical Inspections
Electrical Service Meter-(Meter will be set within 2-3
business days after approval) Excludes New
ructlan
Exterior Plaster (Brown Coat)
T-Bar (Struct., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
• Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05109
Issued: 10/26/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 213
CITY OF ANAHEIM
Site Address: 8173 E CARNATION WAY, ANAHEIM, CA 92808
Legal Description: N TR 10981 BLK LOT 4
APN:35411104
WORKER'S COMPENSATION DECLARATION:
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141 765 - 5153
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of pedury one of the following declarations:
I have and will maintain a certificate of consent to selfainsure for worker's compensation, Issued by the Director of Industrial Relations as provided for by
n Section 3700 of the Labor Code, for the performance of the work for whist this permit is issued.
1 have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued. My worker's Compensation insurance terrier and policy are:
Cartier. SECURITY NATIONAL INSURANCE COMPANY Policy No.: SWC1303694 Expiration Date: 3/3/2023
Name of Agent: Phone No.:
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the
workefs compen ' we of California, and agree that, If I should become subject to the worker's compensation provisions of Section 3700 of the
Labor shall forthwith comply with those provisions.
- l d :04
Signature o Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit Is Issued
(Sec.3097.Civ.C):
Lender's Name:
Lender's Address:
LICENSED CONTRACTOR'S DECLARATION:
I hereby affirm under the penalty of Perjury that 1 am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, rise Is In full force and effect.
r0�
Conuft9gignTure Date
NUMBER EXPIRATION DATE LICENSE TYPE (Sl
871067 01/31/2024 C10, C36, C20